Medical conditions
Hearing loss and tinnitus
Tinnitus is the perception of ringing or other sounds when there is no external source. It is often associated with hearing loss. While there is no cure, there are many effective ways to reduce its impact and perception. Start with a hearing test.
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Tinnitus
What is tinnitus?
Tinnitus is a sound generated inside the hearing system rather than from an external sound source. It is most often described as ringing, but can take the form of buzzing, hissing, whooshing, humming, clicking or a tone. It may be heard in one ear, in both, or feel as though it comes from inside the brain. Tinnitus can be constant or intermittent, faint or loud, and it is usually most noticeable in quiet, at night, or when you are tired or stressed.
Almost everyone experiences brief tinnitus at some point, after a concert or in a silent room. It becomes a problem when it is persistent and intrudes on sleep, concentration or peace of mind: the quiet at bedtime, reading a book, a conversation across the dinner table. Around one in ten adults has ongoing tinnitus, and for a smaller number, it is severe enough to affect their daily lives.
Causes
What causes tinnitus
Tinnitus is a symptom, not a disease, and it has many possible triggers. The most common include:
- Hearing loss. By far the most frequent companion of tinnitus. When the inner ear sends fewer signals to the brain, the brain increases its own sensitivity, and that increased activity is perceived as tinnitus.
- Noise exposure. A loud concert, a power tool, a firearm. Noise can cause temporary tinnitus that fades, or, with repeated exposure, permanent tinnitus alongside hearing loss.
- Ear wax. A blocked ear canal can trigger or worsen tinnitus. This is one of the easiest causes to fix.
- Age. Tinnitus becomes more common with age, like age-related hearing loss.
- Medications. High doses of aspirin, some antibiotics, some diuretics and chemotherapy drugs can cause or worsen tinnitus.
- Ear and jaw conditions. Ear infections, Ménière's disease, otosclerosis, and problems with the jaw joint (TMJ) are all associated with tinnitus.
- Head and neck injury.
- Stress, fatigue and poor sleep. These do not cause tinnitus, but they often make it louder and harder to ignore. Caffeine, alcohol and nicotine can also make tinnitus more noticeable for some people.
If your tinnitus arrived with sudden hearing loss, call us the same day: sudden hearing loss is often treatable with steroids if treatment starts within the first 24 to 48 hours. If we are closed, go straight to an emergency department. If your tinnitus pulses in time with your heartbeat, is present in one ear only, or is accompanied by dizziness, tell us when you book. We check for these patterns at your hearing test and refer you to a physician if needed.
The link
How tinnitus relates to hearing loss
Most people with persistent tinnitus have some degree of hearing loss, even if they may not have noticed it. Often the pitch of the tinnitus matches the pitches at which hearing thresholds are reduced. The leading explanation is that when the inner ear stops sending the brain certain frequencies, the brain's hearing centres become more active as they search for those missing frequencies, and that activity is perceived as sound.
This is why a hearing test is the first step for tinnitus. The test shows whether there is a hearing loss, which pitches are affected, and whether the loss explains the tinnitus. The same explanation is why restoring the missing sound with hearing aids so often helps: the brain receives the desired input, which can make tinnitus less noticeable.
What we offer
Managing tinnitus at Hear & Co
There is no cure for tinnitus. Management approaches and hearing aids can assist in masking the tinnitus and in reducing its impact and intensity.
A hearing test
Every tinnitus visit starts here. We check for wax. If we find wax, we will discuss options for removal with you. We test your hearing to see whether there is a loss, and at what frequencies or pitches.
Hearing aids for tinnitus
Hearing aids help many people with tinnitus, including people who do not have a measurable hearing loss. Restoring everyday sound reduces the contrast between the tinnitus and silence, gives the brain the input it was missing, and takes the strain out of listening. Many current hearing aids from the brands we carry also include a built-in tinnitus feature: a gentle, adjustable background sound that helps the brain tune the tinnitus out. A complimentary demo allows you to experience the benefit for yourself.
Sound therapy
Using external sound to reduce the prominence of tinnitus: a bedside sound generator, a fan, an app with nature sounds or soft noise, or the tinnitus feature in a hearing aid. The aim is not to mask the tinnitus completely, but to reduce its contrast with the sounds around you. This can make the tinnitus less perceptible.
Counselling and information
Following a hearing test, the hearing health care professional will counsel you on the results and their relationship with your tinnitus, and on how the brain gradually learns to ignore it through a process called habituation. For people whose tinnitus causes significant distress, we recommend following up with your physician for next steps.
Protecting your hearing
If noise is part of your recreational activities, such as attending concerts or playing in a band, custom noise plugs or musicians' earplugs can reduce the sound exposure to a safe level.
Everyday habits
Managing stress, protecting sleep, limiting caffeine and alcohol if they worsen your tinnitus, and keeping some gentle background sound in quiet rooms all help reduce the extent to which tinnitus feels intrusive or has a negative impact.
Red flags
When we refer you to a physician
Come to us first for wax removal, a hearing test and tinnitus management. We will refer you to your family doctor if your tinnitus:
- Beats in time with your pulse
- Is present in one ear only
- Started suddenly along with hearing loss or dizziness. For a sudden hearing loss, call us the same day; if we are closed, go to an emergency department.
- Followed a head injury
- Is accompanied by pain, discharge or facial weakness
We will tell you if anything on your test requires a visit back to your GP.
Good to know
Tinnitus questions
Do hearing aids help tinnitus?
Tinnitus relief with hearing aids is common. Hearing aids restore the sound the brain was missing and reduce the contrast that makes tinnitus perceptible. Hearing aids also help many people who experience tinnitus but do not have a measurable hearing loss. A complimentary demo allows you to experience the benefit for yourself.
Is there a cure for tinnitus?
No. There is no treatment that “fixes” tinnitus. There are well-established ways to make tinnitus much quieter and less bothersome. For many people, the perception of tinnitus fades with time and the right management.
Why is my tinnitus worse at night?
Because it is quiet. With no outside sound to compete with, the brain has nothing to listen to but the tinnitus. Soft background sound at bedtime, from a fan, an app or a bedside sound generator, is the standard remedy. You are also more tired at night, and tinnitus is often more prominent when you are tired.
Can ear wax cause tinnitus?
Yes. A blocked canal can start or worsen tinnitus, and removing the wax often resolves the issue. Wax is the first thing we check for.
Who should I see about tinnitus?
Start with a hearing test at a hearing clinic, because hearing loss is the most common cause and the most manageable. If anything on your test needs medical attention, we will refer you to your family doctor, who can make the appropriate referral.
Does stress make tinnitus worse?
Reliably, yes. Stress, fatigue and poor sleep all increase the intensity of tinnitus. Managing stress, fatigue and sleep is part of managing tinnitus.
Book
Start with a hearing test
A hearing test is the first step, and it is complimentary for anyone 55 and over. It shows whether there is wax to remove or a hearing loss to address, and we can begin treatment options at the same appointment or provide recommendations for a referral if needed. Book an appointment online.